Simultaneous development of Fanconi syndrome and acute renal failure associated with cidofovir
| Autor: | Amir Kazory, Salman Singapuri, A. Ahsan Ejaz, Anuradha Wadhwa |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Pharmacology
Microbiology (medical) Chemotherapy medicine.medical_specialty business.industry medicine.medical_treatment Mucormycosis Fanconi syndrome Disease medicine.disease Gastroenterology Nephrotoxicity chemistry.chemical_compound Infectious Diseases chemistry Internal medicine Toxicity medicine Pharmacology (medical) Intensive care medicine business Haematological malignancy Cidofovir |
| Zdroj: | Journal of Antimicrobial Chemotherapy. 60:193-194 |
| ISSN: | 1460-2091 0305-7453 |
| DOI: | 10.1093/jac/dkm143 |
| Popis: | found to be predictive of survival in a large study not including HIV-infected patients; most of these patients died within 3 months due to mucormycosis itself, and those who responded to antifungal treatment died because of the clinical progression of the underlying haematological malignancy. To our knowledge, this is the first report assessing a .2-year-long survival in a patient with both advanced HIV infection and a haematological malignancy. Such prolonged survival, despite the relapse of the underlying haematological disease, suggests that the weekly long-term administration of liposomal amphotericin B at high dosage might prevent the clinical and the radiological progression of mucormycosis, even if its complete eradication does not seem achievable. Additionally, this approach might allow the administration of a full dose chemotherapy for the underlying haematological disease. Liposomal amphotericin B has usually moderate long-term toxicity, involving primarily kidneys or liver; as a consequence, periodic evaluation of renal and hepatic parameters is required. The duration and the correct dosage of the maintenance treatment for rhinocerebral mucormycosis are both unknown. We might speculate that the antifungal treatment should be continued until the underlying cause of immune-suppression persists. At the moment, data on combination treatment for mucormycosis are only sporadically reported; therefore, the clinical implications of this approach are not well understood. Additionally, economic and careproviding implications need to be considered when treating these subjects for a prolonged period. The empirical administration schedule of liposomal amphotericin B proposed in this case report may represent a possible option to treat mucormycosis in rare conditions. |
| Databáze: | OpenAIRE |
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